CHARACTERISTICS OF CHILDREN HOSPITALIZED WITH INFECTIVE

ENDOCARDITIS AT MOHAMMAD HOESIN HOSPITAL PALEMBANG

Andra Kurnianto, Ria Nova
Department of Child Health
Medical School, University of Sriwijaya/Mohammad Hoesin Hospital Palembang
Abstract
Background. Infective endocarditis (IE) in children is rare 0.5 to 1 of every 1000 hospital
admissions and potentially life-threatening illness. IE is one of the complications that can
occur in children with heart disease.
Objective. To assess the characteristics of children with infective endocarditis in
Mohammad Hoesin Hospital Palembang.
Methods. A cross sectional study was conducted in IE patients who were admitted in
Pediatric Department of Mohammad Hoesin Hospital Palembang from 2011-2013. The
diagnosis based on modified Duke criteria. Echocardiography was performed to evaluate
endocardial involvement and valvular involvement.
Result. There were 23 IE consisted of 9 (39%) boys and 14 (61%) girls. Mean age was
8.5 (SD 5) years old. There were 16 (70%) patients with congenital heart disease (CHD)
and 7 (30%) patients with rheumatic heart disease (RHD). From 16 patients CHD showed
7 (30%) VSD; 6 (26%) PDA; 2 (8.6%) TOF; 1 (4.3%) TGA. There were positive blood
cultures 16 (70%) and 7 (30%) negative blood cultures. From 16 positive blood culture
showed 4 (17.4%) S.Viridans; 11 (47.8%) S.Aureus; 1 (4.3%) Enterococci. Antibiotic
therapy consisted of 14 (61%) ampicillin gentamycin; 1 (4.3%) ampicillin gentamycin
ceftazidime; 3 (13%) ampicillin gentamycin ceftriaxone; 1 (4.3%) ampicillin gentamycin
meropenem; 4 (17.4%) ampicillin gentamycin vancomycin. The outcome consisted of 21
(91.4%) discharged and 2 (8.6%) died. There were 23 (100%) patients came with
prolonged fever, 18 (78%) with pallor, 5 (21.7%) with weight loss, 5 (21.7%) with heart
failure, 23 (100%) with leucocytosis, 8 (34.7%) with carious teeth, 2 (8.6%) with clubbing
finger and no one came with hematuria, spleenomegali, seizure, roth spots, janeway
lesion, osler nodes.
Conclusion. IE at Mohammad Hoesin Hospital Palembang usually came with mean age
8.5 (SD 5) years old and occurs more often with VSD than other heart diseases.
S.Aureus is the most common bacteria found in blood cultures. Ampicillin gentamycin is
the most common antibiotic used in IE. IE usually came with prolonge fever and
leucocytosis.
Key words. Characteristic infective endocarditis, children.